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Korean Forum of Aesthetic Surgery (KFAS)2015 ソウル、韓国 2015/03/28-29

Glabella and forehead augmentation in Oriental rhinoplasty

It is important to take into account the contour line from the forehead to the nasal dorsum. From this point of view, the nasal radix (sellion) is the key point. The standard dorsal augmentation raises the radix anteriorly and superiorly. Excessive or careless augmentation raises the radix over the normal range, making an unnatural look. In order to avoid the unnatural outcome, we have introduced the glabella augmentation and forehead augmentation in Oriental rhinoplasty.

The injection of short-lasting hyaluronic acid is used for presurgical simulation. The increased thickness of the forehead is measured and used as a blueprint of the operation. 3D skull model is manufactured based on CT-scan in each patient. The custom made silicone implant is made to raise the forehead, glabella and nasal dorsum with the thickness obtained in the simulation. The bottom surface of the implant can fit in with the skull and dorsal cartilage vault of each patient.

The silicone implant is inserted in position using a 4 cm long incision in the frontal area and endonasal or open rhinoplasty incision. The upper eyelid incision was very helpful to visualize the accurate positioning at the superior orbital rim.

The forehead augmentation was effective to give the oriental eye a sculptured feature. It was also found useful to make a harmony in the projection of glabella and nasal root. The simulation with hyaluronic acid was very valuable to provide the patient with prospective and the surgeon with precise surgical planning.

Announcement by the slide

These 3 patients look unnatural because the nasal root is too high in relation with the forehead .

 ・The forehead augmentation with methyl methacrylate makes the sellion look hollowed.
 ・2 mm thick PTFE are layered in three for augmentation of nasal dorsum and glabella. They are fixed with suture.